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■ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—w�wi.everetiwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ..��L'�_` _ A�� _' ; '(.',irl� � a -� <br /> I�,c ,� � � � � �,_ � <br /> PROJECT ADDRESS <br /> li ��. U. �:�.�. �x�. `� �- ��,. n �: 1�. �� �i� � �� .i� W�' '1 -�'I:.•i - ���.c�� l <br /> Ownef Mntl AAdress C�ry Slale/Zip Phone <br /> � . <br /> Ib,r" j, i•,.� . � ,. <br /> Tenant Mad Address Clty Slate2ip Phore <br /> �-c��� Z.�l ��.li.u.. l- .it_.lnn_ �' fi1% (' � Ir 1�� 1�` '�Fil � '�� i. 7�.�� <br /> �_- fJ�..� �C•.. ,. u .:�-i �r � � �� <br /> Electncal Contraclor Mail�nAress Gty Siate�Z�p Phone <br /> i� ' <br /> � ,li.��,.c��s-��- I� �r � <br /> �: i�-L-' <br /> State License Number Contrect Price of Work <br /> Proposed Use of Buildmg Contdd Person (Plan Review� <br /> Uescnption ol Work to Be Done � � � � � � � � � � � r�• � <br /> NOTE WIRING IN NON-DWELLINGS IS RE4UIRED TO FEE <br /> D[ IN RACEWAYS, MC OR AC CABLE <br /> ' �C� ,' , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS:1105 <br /> I lrereby cnriJy fhaf 1 havo rnud and e�amined fhrs appOr.ahon and know dre sarne fo Ge fnio and <br /> ronecf All piovis�ons olla�vs anAn�drnancr.s govemrng fhis type ol�vo�k wrll be complefad <br /> w���rne�snAcd�ed nere�n o.�,or The granfing o�a pemnf Aoes nol resurne fo grve aufhonty fo <br /> v�olalo or cancel tl�e provisions ol e�ry ofher sfale or local law reguP6ng cons(rucGon or fhe <br /> pr.rformanc�ol consfruc(ron Tha(I nrn aufhonzeAby fhe o�vner ol fhis p,opeRy fa perform fhe <br /> unrk/or whrclr apphcahon�s rnaAe and I comply wRh fhe Sfa1e Confrar.tors Lau- 1 S 27 RCW and <br /> 796 200 WAC � <br /> - , � 7 <br /> � i '.•Y ' _ ' 1 /� p' � ' / <br /> >�itfWIWP .TIC . . . . <br /> � � <br />